Methods and systems for modifying operational data of an interaction process or of a process for determining an instruction

ABSTRACT

It is inter alia disclosed to perform at least one of operating an interaction process with a user of the medical apparatus and determining, based on a representation of at least one instruction given by the user, at least one instruction operable by the medical apparatus. Therein, the at least one of the operating and the determining at least partially depends on operational data. It is further disclosed to receive modification information for modifying at least a part of the operational data, wherein the modification information is at least partially determined based on an analysis of a representation of at least one instruction given by the user.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 13/697,821, filed Feb. 12, 2013, which is a U.S. National PhaseApplication pursuant to 35 U.S.C. §371 of International Application No.PCT/EP2011/058083 filed May 18, 2011, which claims priority to EuropeanPatent Application No. 10163305.5 filed May 19, 2010. The entiredisclosure contents of these applications are herewith incorporated byreference into the present application.

FIELD OF INVENTION

The present invention relates to the interaction between a user and amedical apparatus and/or to the determination of instructions that maybe given by the user in such an interaction.

BACKGROUND

A variety of diseases exists that require regular treatment, which maybe supported by use of a medical apparatus.

Examples of such a medical apparatus include an injection device forinjecting doses of a medicament. Injection devices are used either bymedical personnel or by patients themselves. As an example, type-1 andtype-2 diabetes can be treated by patients themselves by injection ofinsulin doses, for example once or several times per day.

However, in particular older patients and/or patients inexperienced inthe use of such a medical apparatus may feel uncomfortable andoverstrained when using such a medical apparatus.

To account for this, medical apparatuses with an intuitive usability andinteractive guidance have been developed, so that patients feel moreconfident and comfortable when using such medical apparatuses.

As an example, medical apparatuses with speech recognition capabilitiesprovide intuitive usability and interactive guidance. In this respect,German patent application DE 100 38 936 A1 discloses an injection devicefor facilitating an adjusting procedure of a dosage of the medicamentthat is to be injected. This is for instance achieved by providing anaudible feedback about the adjusted dosage to the user of the injectiondevice and by recognizing defined speech instructions given by the user.

However, speech recognition of the injection device of DE 100 38 936 A1is limited to a defined set of recognizable speech instructions. Thus, auser of such an apparatus experiences a low intuitivity due to thelimited set of recognizable speech instructions and may suffer fromfrustration due to low recognition accuracy of speech instructions thatdeviate from the defined set of recognizable speech instructions.

SUMMARY

It is thus inter alia an object of the present invention to provideapparatuses, a system, methods and computer programs allowing for animproved interaction between a user and a medical apparatus.

According to a first aspect of the present invention, a medicalapparatus is disclosed, comprising a processor configured to perform atleast one of operating an interaction process with a user of the medicalapparatus and determining, based on a respective representation of atleast one instruction given by the user, at least one instructionoperable by the medical apparatus, wherein the at least one of theoperating an interaction process and the determining at least oneinstruction at least partially depends on operational data; and acommunication unit configured to receive modification information formodifying at least a part of the operational data, the modificationinformation at least partially determined based on an analysis of arespective representation of at least one instruction given by a user.

In this first aspect of the present invention, furthermore a method isdisclosed, comprising at least one of operating an interaction processwith a user of the medical apparatus and determining, based on arespective representation of at least one instruction given by the user,at least one instruction operable by the medical apparatus, wherein theat least one of the operating and the determining at least partiallydepends on operational data; and receiving modification information formodifying at least a part of the operational data, the modificationinformation at least partially determined based on an analysis of arespective representation of at least one instruction given by a user.

In this first aspect of the present invention, furthermore a computerprogram is disclosed, comprising program code for performing the methodaccording to the first aspect of the present invention when the computerprogram is executed on a processor. The computer program may forinstance be distributable via a network, such as for instance theInternet. The computer program may for instance be storable or encodablein a computer-readable medium. The computer program may for instance atleast partially represent software and/or firmware of the processor.

In this first aspect of the present invention, furthermore acomputer-readable medium is disclosed, having a computer programaccording to the first aspect of the present invention stored thereon.The computer-readable medium may for instance be embodied as anelectric, magnetic, electro-magnetic, optic or other storage medium, andmay either be a removable medium or a medium that is fixedly installedin an apparatus or device. Non-limiting examples of such acomputer-readable medium are a Random-Access Memory (RAM) or a Read-OnlyMemory (ROM). The computer-readable medium may for instance be atangible medium, for instance a tangible storage medium. Acomputer-readable medium is understood to be readable by a computer,such as for instance a processor.

In this first aspect of the present invention, furthermore a medicalapparatus is disclosed, configured to perform the method according tothe first aspect of the present invention.

According to a second aspect of the present invention, an apparatus isdisclosed, comprising a processor configured to perform determining,based on an analysis of a respective representation of at least oneinstruction given by a user of a medical apparatus, the medicalapparatus configured to perform at least one of operating an interactionprocess with a user of the medical apparatus and determining at leastone instruction operable by the medical apparatus in dependence onoperational data, modification information for modifying at least a partof the operational data; and a communication unit configured to transmitthe modification information.

In this second aspect of the present invention, furthermore a method isdisclosed, comprising determining, based on an analysis of a respectiverepresentation of at least one instruction given by a user of a medicalapparatus, the medical apparatus configured to perform at least one ofoperating an interaction process with a user of the medical apparatusand determining at least one instruction operable by the medicalapparatus in dependence on operational data, modification informationfor modifying at least a part of the operational data; and transmittingthe modification information.

In this second aspect of the present invention, furthermore a computerprogram is disclosed, comprising program code for performing the methodaccording to the second aspect of the present invention when thecomputer program is executed on a processor. The computer program mayfor instance be distributable via a network, such as for instance theInternet. The computer program may for instance be storable or encodablein a computer-readable medium. The computer program may for instance atleast partially represent software and/or firmware of the processor.

In this second aspect of the present invention, furthermore acomputer-readable medium is disclosed, having a computer programaccording to the second aspect of the present invention stored thereon.The computer-readable medium may for instance be embodied as anelectric, magnetic, electro-magnetic, optic or other storage medium, andmay either be a removable medium or a medium that is fixedly installedin an apparatus or device. Non-limiting examples of such acomputer-readable medium are a Random-Access Memory (RAM) or a Read-OnlyMemory (ROM). The computer-readable medium may for instance be atangible medium, for instance a tangible storage medium. Acomputer-readable medium is understood to be readable by a computer,such as for instance a processor.

In this second aspect of the present invention, furthermore an apparatusis disclosed, configured to perform the method according to the secondaspect of the present invention.

According to a third aspect of the present invention, a system isdisclosed, comprising a medical apparatus according to the first aspectof the present invention and an apparatus according to the second aspectof the present invention.

In the following, features and embodiments (exhibiting further features)of the present invention will be described, which are understood toequally apply to the apparatuses, methods, computer programs andcomputer-readable media of the first and second aspect of the presentinvention, and also to the system according to the third aspect of thepresent invention. These single features/embodiments are considered tobe exemplary and non-limiting, and to be respectively combinableindependently from other disclosed features/embodiments of apparatuses,methods, computer programs and computer-readable media of the first andsecond aspect of the present invention and the system according to thethird aspect of the present invention as described above. Nevertheless,these features/embodiments shall also be considered to be disclosed inall possible combinations with each other and with the apparatuses,methods, computer programs and computer-readable media of the first andsecond aspect of the present invention and the system according to thethird aspect of the present invention as described above.

Furthermore, a mentioning that an apparatus according to one of theaspects of the present invention performs (or is configured or arrangedto perform) a certain action should be understood to also disclose acorresponding method step of the method according to the respectiveaspect of the present invention and a corresponding program code of thecomputer program according to the respective aspect of the presentinvention.

According to the present invention, the medical apparatus may forinstance comprise a processor configured to perform operating aninteraction process with a user of the medical apparatus.

Further, the medical apparatus may for instance comprise a processorconfigured to perform determining, based on a respective representationof at least one instruction given by the user, at least one instructionoperable by the medical apparatus.

In an example embodiment, the medical apparatus may for instancecomprise a processor configured to perform operating an interactionprocess with a user of the medical apparatus and determining, based on arespective representation of at least one instruction given by the user(for instance in the interaction process), at least one instructionoperable by the medical apparatus.

At least one instruction is given by the user, and a respectiverepresentation of the at least one instruction given by the user is usedas a basis for determining at least one instruction operable by saidmedical apparatus. Therein, if only one instruction is given by theuser, a representation of this instruction is used, and if two or moreinstructions are given by the user, representations of these two or moreinstructions are used, for instance a first representation for a firstinstruction, a second representation for a second instruction, etc.

The determining, based on a respective representation of at least oneinstruction given by the user, the at least one instruction operable bythe medical apparatus may for instance comprise interpreting arepresentation of an instruction given by the user and/or mapping, atleast partially based on the results of the interpreting, therepresentation of the instruction given by the user to an instructionoperable by the medical apparatus (for instance an instruction from alimited set of instructions that can be operated by the medicalapparatus) that causes the medical apparatus to perform a relatedaction. For instance, in the context of injection of medicament doses,the user may speak the instruction “dial 50 units of insulin” and/or“start injection” and, accordingly, the medical apparatus may dial thedesired dose of insulin and/or start the injection procedure. In casethat the interpreting (or the interpretation, respectively) and/or themapping fails, the medical apparatus may for instance require the userto give the instruction again or offer action alternatives.

Both, the interpreting and the mapping, is at least partially based onoperational data.

The representation of an instruction given by the user may for instancerepresent the instruction given by the user in a form in which it issensed and/or processed by means of the medical apparatus, for instancein the form of a signal. Such means may for instance be a sensorconfigured to capture a signal inputted on a keyboard, a touch-screendevice, an adjustment wheel, a button, etc., and/or a means forcapturing an acoustical signal (for instance spoken speech, handclapping, etc.) and/or a means for capturing a visual signal. Due tonoise or non-ideal sensor characteristics, the representation of theinstruction given by the user may for instance contain additional orless information than the instruction given by the user actuallycontained. The medical apparatus may for instance comprise more than oneof such means/sensors.

It is to be noted that an instruction given by the user is not limitedto instructions such as commands, but may for instance be a question, ashort (for instance responsive) statement (for instance a single speechinstruction) such as yes, no or a number (for instance to indicate tothe apparatus to proceed with a respective action).

The operating of an interaction process with a user may for instancecomprise determining a reaction that is to be performed by the medicalapparatus in response to an action performed by the user. Therefore, theprocessor configured to perform operating an interaction process may forinstance receive information associated with an action performed by theuser (for instance a representation of an instruction given by the user,an electronic signal corresponding to such a representation or a changeof the status of the medical apparatus) as an input and, at leastpartially based on this input and on the operational data, the processorthen may determine a related reaction.

Accordingly, the interaction process may for instance comprise at leastone action performed by the user on the medical apparatus and at leastone reaction performed by the medical apparatus in response to thisaction. Alternatively, the interaction process may for instance compriseat least one action performed by the medical apparatus requiring theuser to perform at least one reaction on the medical apparatus inresponse to this action. However, the interaction process is not limitedto one action and one reaction, it may comprise several actions andreactions, wherein one or more actions and/or reactions may be dependingon one or more previous actions and/or reactions performed in the flowof the interaction process, so that for instance a verbal/non-verbaldialogue or the like takes place between the user and the medicalapparatus. This dialogue may also be partially verbal and partiallynon-verbal.

An action or a reaction performed by the medical apparatus may forinstance be to generate a signal by appropriate means. Such means mayfor instance be a presentation unit at least comprising one of a visualsignal generator (for instance a display device, an indicator light,etc.), an acoustical signal generator (for instance a speaker, a buzzer,etc.), a mechanical signal generator (for instance a vibrator, a Brailledisplay, etc.) or the like.

Parts of the operational data may for instance define how an interactionbetween the medical apparatus and the user is structured, for instance,what actions and/or instructions are requested and/or expected from theuser, and in which sequence. Parts of the operational data may forinstance also or alternatively form a basis for the recognition and/orinterpretation of instructions given by the user, for instance in theform of databases and/or rules pertaining to and/or defining thisrecognition/interpretation. The operational data may for instancecomprise rules for the determining and/or the operating, such as forinstance determining rules, flow rules, and interpretation rules. Theoperational data may at least partially be stored in a volatile or anon-volatile storage unit that may at least temporarily be comprised inthe medical apparatus.

Additionally or alternatively, the storage unit may for instancecomprise an operating and/or determining record, which may for instancecontain information about at least one previous interaction process (forinstance respective representations of actions and reactions of such aninteraction process), about respective representations of instructionsgiven by users and respectively determined instructions, medical data(for instance date and dose of injections performed by an injectiondevice), user-specific data, data about device failures and user errors,general data, and/or the like. It may be updated on a regular basis, forinstance before, during or after the determining and/or the operating.

The operational data may for instance be modified by instructions thatare comprised in the modification information and are operable by theprocessor of the medical apparatus (or another processor). For instance,instructions for replacing at least a part of the operational data (forinstance with data comprised in the modification information), fordeleting at least a part of the operational data, for adding new data(for instance comprised in the modification information) to theoperational data and/or the like may be comprised in the modificationinformation. Such modifications may also be performed by a user of themedical apparatus, for instance via a user interface. This may requireproper authorization of this user.

The analysis based on which the modification information is determinedand/or the determining of the modification information is performed byan entity which is not part of the medical apparatus. One or bothactions may for instance be performed by the apparatus according to thesecond aspect of the invention. Therein, the entity may comprise aprocessor configured to perform the analysis and the determining, orseparate processors for these tasks.

The analysis may at least partially comprise determining a respectiveinstruction operable by the medical apparatus based on a respectiverepresentation of at least one instruction given by a user of themedical apparatus. To this end, the information on the respectiverepresentation of the at least one instruction given by the user has tobe provided to the entity that performs the analysis. In the context ofspeech recognition, for instance a representation of at least oneinstruction given by the user and not recognized by the medicalapparatus (for instance due to unclear pronunciation of the user and/ordue to uncommon use of nomenclature) may be analyzed to determine aninstruction operable by the medical apparatus that matches theinstruction given by the user. The modification information may then bedetermined accordingly to ensure that the same instruction given by theuser is recognized by the medical apparatus in the future.

Furthermore, the analysis may for instance also or alternativelycomprise comparing the respective instruction determined by the entitywith a respective instruction determined by the medical apparatus inresponse to the same respective representation of the at least oneinstruction given by the user, for instance to detect erroneous ornon-optimum decisions made by the medical apparatus. To this end,information (e.g. a representative code) on the respective instructiondetermined by the medical apparatus has to be provided to the entitythat performs the analysis. The modification information may then bedetermined to avoid erroneous or non-optimum decisions of the medicalapparatus in the future.

The analysis may for instance also or alternatively comprise comparing arespective representation of at least one user instruction given by auser of the medical apparatus in the flow of an interaction process withanother respective representation of at least one user instruction givenby the user in the flow of a previous interaction process, or processingrespective representations of at least one user instruction given by oneor more users of one or more medical apparatuses in several interactionprocesses (for instance in response to the same question asked to the atleast one user in the interaction process). Such information may forinstance be analyzed to determine a set of instructions frequently givenby the user or users and may be considered when determining modificationinformation, so that for instance the most frequent of all instructionsgiven by the user(s) so far can be recognized by the medical apparatusin the future.

The determining of the modification information may allow thesupplementary adaptation of the operating and the determining forinstance with respect to a specific user. Thus, the medical apparatus ofthe first aspect of the present invention is highly flexible andadaptable.

According to an embodiment of the present invention, the at least oneinstruction is given acoustically by the user and the determining is atleast partially based on speech recognition of the respectiverepresentation of the at least one instruction given by the user.Similarly, the analysis based on which the modification information isdetermined may for instance be at least partially based on speechrecognition of the respective representation of the at least oneinstruction given by the user.

Accordingly, the instruction given by the user may for instance be aspeech instruction spoken by the user, wherein, in this respect, speechinstruction basically relates to any arbitrary speech sounds such as oneor more spoken words (i.e. one or more sentences), one or more portionsof a spoken word, a single spoken syllable or the like.

The respective representation of the at least one speech instructiongiven by the user may for instance be captured by an acoustical sensor(e.g. one or more microphones) of the medical apparatus. Initially, thisrespective representation is thus for instance an electronic signalcorresponding to an acoustical representation of the at least one speechinstruction, which may for instance be sampled and quantized andsubsequently encoded according to a digital audio format, such as forinstance the Moving Picture Experts Group (MPEG)-1 Audio Layer 3 (MP3)format or the like. For instance, the acoustical representationcomprises the information necessary to play back the sensed speechinstruction (e.g. by means of an acoustical signal generator).

The processor configured to perform determining the instruction operableby the medical apparatus based on the respective representation of theat least one speech instruction given by the user may for instance befurther configured to perform speech recognition on the representationof the at least one speech instruction given by the user. Therein, thespeech recognition may for instance relate to the recognition and/orinterpretation of the respective representation of the at least onespeech instruction given by the user. This may for instance comprisetranscribing the acoustical representation into a text-basedrepresentation (for instance speech-to-text conversion), so that atextual representation of the instruction given by the user (or theinstruction determined in response to the instruction given by the user)can be visualized, for instance on a display of the medical apparatus.For instance, the text-based representation comprises the textualinformation (e.g. the words spoken by a user) of the acousticalrepresentation; however, it may for instance not comprise informationabout the pronunciation/articulation of the words spoken by a userand/or the like.

Furthermore, the processor may for instance be configured to map thistext-based representation to an instruction (for instance an instructionfrom a limited set of instructions) operable by the medical apparatusthat causes the medical apparatus to perform an action according to thedetermined instruction given by the user. The mapping may for instancecomprise key-word spotting, contextual analyses based on sensedparameters of the user and/or the medical apparatus, etc. Alternatively,the respective representation of the at least one speech signal given bythe user, or parts thereof, may be directly mapped into an instructionoperable by the medical apparatus in the process of speech recognition.

According to an embodiment of the present invention, the speechrecognition at least partially depends on the operational data, and atleast a part of the modification information is determined to improvethe speech recognition with respect to the user.

The improvement of the speech recognition may for instance relate to ahigher accuracy of the speech recognition (for instance resulting in alower word error rate) and/or a faster speech recognition (for instanceresulting in a smaller real-time factor).

A higher accuracy of the speech recognition may for instance be achievedby modifying the part of the operational data on which the determiningof the at least one instruction operable by the medical apparatus isbased. This part (which may for instance comprise a set of rules) mayfor instance consider the specific articulation of specific words of aspecific user, a specific vocabulary used by a specific user, specificstatistics associated with a specific user (such as probabilities ofspecific instructions) or the like.

Alternatively or additionally, a higher accuracy of the speechrecognition and/or faster speech recognition may for instance beachieved by modifying the part of the operational data (which may forinstance comprise a set of rules) that at least partially defines howthe interaction process is operated. This part may for instance considerspecific statistics associated with the user (such as probabilities ofspecific instructions) or the like. For instance, several instructionsfrequently given by the user in response to a single request in the pastmay be requested from the user in multiple single requests within theflow of the interaction, so that the user can respond by using simple(single) speech instructions.

According to an embodiment of the present invention, the processor mayfurther be configured to recognize a user of the medical apparatus.Modifications of the operational data with respect to the user (forinstance user-specific operational data) may then for instance only beconsidered and/or implemented by the processor if the respective user isrecognized. Similarly, the recognition of a user may for instance benecessary to authorize the use of the medical apparatus. The recognitionof the user can for instance be performed by speaker recognition.

According to an embodiment of the present invention, the operationaldata is at least partially associated with at least one of an acousticmodel, a language model and a wordbook for the speech recognition. Someor all of the acoustic model, the language model and the wordbook may beuser-specific. The acoustic model, the language model and the wordbookmay also be specific to a group of users, for example users with thesame language, the same or a similar dialect, a similar property of thevoice (e.g. high or low pitch, speed of voice, variation in pitch orspeed, etc.).

Initially, the speech recognition may for instance at least partiallydepend on a general acoustic model, a general language model and/or ageneral wordbook; and these general models may for instance be adaptedto a specific user or a group of users by the modification information.

The acoustic model may for instance comprise sound patterns of sequencesof words, words, syllabuses and letters; the word book may for instancecomprise the recognizable vocabulary of the speech recognition; and thelanguage model may for instance comprise a grammar model or statisticalmodel for determining the most probable sequences of words, words,syllabuses and letters.

According to an embodiment of the present invention, the processor ofthe medical apparatus is further configured to present the respectiverepresentation of the at least one instruction given by the user and theat least one determined instruction. Alternatively, the processor of themedical apparatus may for instance be configured to present at least oneof the respective representation of the at least one instruction givenby the user and the at least one determined instruction.

In this way, a possibly dangerous misinterpretation and/or an erroneousmapping of the respective representation of the user instruction to aninstruction operable by the medical apparatus may be avoided, since theuser may respond to the presentation of the respective representation bygiving a further instruction (e.g. a corrective feedback). The medicalapparatus may thus for instance comprise a button for confirming and/orrejecting the respective representation of the at least one instructiongiven by the user and/or the at least one determined instruction.

According to an embodiment of the present invention, the modificationinformation is at least partially determined based on an analysis of arespective representation of at least one instruction given by a user inresponse to the presentation (i.e. the presentation of the respectiverepresentation of the at least one instruction given by the user and theat least one determined instruction). The instruction given by the userin response to the presentation provides a feedback that may beconsidered by determining the modification information (and altering theoperational data) accordingly. To this end, information on this feedbackmay be provided to the entity that performs the analysis.

For instance, an initially erroneously determined instruction operableby the medical apparatus (for instance based on a representation of aspeech instruction given by the user) may be corrected by a user inresponse to the presentation of the determined instruction, so that, inthe future, the speech instruction can be mapped to the correctinstruction operable by the medical apparatus.

According to an embodiment of the present invention, the operationaldata is at least partially associated with rules defining at least oneof a flow of the interaction process and information provided to theuser in the interaction process. These rules may for instance bespecific for a user or a class of users, but may alternatively also begeneral for a large variety of users.

According to an embodiment of the present invention, at least a part ofthe modification information is determined to modify at least one of theflow of the interaction process and the information provided to the userin the interaction process.

This determined modification information may for instance considerspecific statistics associated with the user (such asprobabilities/frequencies of specific instructions), highlyprobable/frequent flows of the interaction process and/or the like.Accordingly, the interaction process may for instance be adapted to aspecific user. For instance, if a user has always or at least frequently(for instance always after the first use) skipped certain steps of theinteraction, this may be considered in the modification information, andthe part of the operational data defining the interaction may be alteredaccordingly to exclude these frequently skipped steps. The determinedmodification information may for instance also relate to user-specificdata (such as measured parameters of the user, a recommended treatment,medical data, data comprised in the operational data, etc.).

According to an embodiment of the present invention, the interactionprocess is part of a guidance provided to the user.

The guidance may for instance provide support to the user by providinghelp, training and/or information (e.g. information regarding exercises,nutrition, diets, administrable drugs and/or the like). This provisionmay for instance happen in response to a request by the user, or may beat least partially automatically.

According to an embodiment of the present invention, the communicationunit of the medical apparatus is further configured to transmit therespective representation of the at least one instruction given by theuser based on which the analysis is performed. Additionally, theapparatus according to the second aspect of the present invention maycomprise a communication unit configured to transmit the modificationinformation to the medical apparatus.

The receiving and/or the transmitting of the data performed by themedical apparatus and the apparatus according to the second aspect ofthe present invention may for instance be performed over a wirelessand/or a wire-bound link. The wireless link may be based on radio waves,optical waves, sound waves, but also on magnetic or electric fields, toname but a few non-limiting examples.

According to an embodiment of the present invention, the medicalapparatus is a medical apparatus configured to administer a medicament.The medical apparatus may for instance be an injection device (such asfor instance an injection pen) or an infusion device (such as forinstance an infusion pump).

Therein a medicament, also frequently referred to as a “drug”, may forinstance be understood to be any substance that, when absorbed into thebody of a living organism, alters normal bodily function, and/or as anysubstance used in the treatment, cure, prevention, or diagnosis ofdisease or used to otherwise enhance physical or mental well-being of acreature. The medicament may for instance be in a solid (e.g. a powder),liquid or gaseous state, or may comprise a mixture of components insolid, liquid and/or gaseous states, such as an aerosol.

The term “medicament”, as used herein, means a pharmaceuticalformulation containing at least one pharmaceutically active compound,

wherein in one embodiment the pharmaceutically active compound has amolecular weight up to 1500 Da and/or is a peptide, a proteine, apolysaccharide, a vaccine, a DNA, a RNA, a antibody, an enzyme, anantibody, a hormone or an oligonucleotide, or a mixture of theabove-mentioned pharmaceutically active compound,

wherein in a further embodiment the pharmaceutically active compound isuseful for the treatment and/or prophylaxis of diabetes mellitus orcomplications associated with diabetes mellitus such as diabeticretinopathy, thromboembolism disorders such as deep vein or pulmonarythromboembolism, acute coronary syndrome (ACS), angina, myocardialinfarction, cancer, macular degeneration, inflammation, hay fever,atherosclerosis and/or rheumatoid arthritis,

wherein in a further embodiment the pharmaceutically active compoundcomprises at least one peptide for the treatment and/or prophylaxis ofdiabetes mellitus or complications associated with diabetes mellitussuch as diabetic retinopathy,

wherein in a further embodiment the pharmaceutically active compoundcomprises at least one human insulin or a human insulin analogue orderivative, glucagon-like peptide (GLP-1) or an analogue or derivativethereof, or exedin-3 or exedin-4 or an analogue or derivative ofexedin-3 or exedin-4.

Insulin analogues are for example Gly(A21), Arg(B31), Arg(B32) humaninsulin; Lys(B3), Glu(B29) human insulin; Lys(B28), Pro(B29) humaninsulin; Asp(B28) human insulin; human insulin, wherein proline inposition B28 is replaced by Asp, Lys, Leu, Val or Ala and wherein inposition B29 Lys may be replaced by Pro; Ala(B26) human insulin;Des(B28-B30) human insulin; Des(B27) human insulin and Des(B30) humaninsulin.

Insulin derivates are for example B29-N-myristoyl-des(B30) humaninsulin; B29-N-palmitoyl-des(B30) human insulin; B29-N-myristoyl humaninsulin; B29-N-palmitoyl human insulin; B28-N-myristoyl LysB28ProB29human insulin; B28-N-palmitoyl-LysB28ProB29 human insulin;B30-N-myristoyl-ThrB29LysB30 human insulin; B30-N-palmitoyl-ThrB29LysB30human insulin; B29-N—(N-palmitoyl-Y-glutamyl)-des(B30) human insulin;B29-N—(N-lithocholyl-Y-glutamyl)-des(B30) human insulin;B29-N-(ω-carboxyheptadecanoyl)-des(B30) human insulin andB29-N-(ω-carboxyhepta-decanoyl) human insulin.

Exendin-4 for example means Exendin-4(1-39), a peptide of the sequence HHis-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile-Glu-Trp-Leu-Lys-Asn-Gly-Gly-Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH2.

Exendin-4 derivatives are for example selected from the following listof compounds:

H-(Lys)4-des Pro36, des Pro37 Exendin-4(1-39)-NH2, H-(Lys)5-des Pro36,des Pro37 Exendin-4(1-39)-NH2, des Pro36 [Asp28] Exendin-4(1-39), desPro36 [IsoAsp28] Exendin-4(1-39), des Pro36 [Met(O)14, Asp28]Exendin-4(1-39), des Pro36 [Met(O)14, IsoAsp28] Exendin-4(1-39), desPro36 [Trp(O2)25, Asp28] Exendin-4(1-39), des Pro36 [Trp(O2)25,IsoAsp28] Exendin-4(1-39), des Pro36 [Met(O)14 Trp(O2)25, Asp28]Exendin-4(1-39), des Pro36 [Met(O)14 Trp(O2)25, IsoAsp28]Exendin-4(1-39); or des Pro36 [Asp28] Exendin-4(1-39), des Pro36[IsoAsp28] Exendin-4(1-39), des Pro36 [Met(O)14, Asp28] Exendin-4(1-39),des Pro36 [Met(O)14, IsoAsp28] Exendin-4(1-39), des Pro36 [Trp(O2)25,Asp28] Exendin-4(1-39), des Pro36 [Trp(O2)25, IsoAsp28] Exendin-4(1-39),des Pro36 [Met(O)14 Trp(O2)25, Asp28] Exendin-4(1-39), des Pro36[Met(O)14 Trp(O2)25, IsoAsp28] Exendin-4(1-39),

wherein the group -Lys6-NH2 may be bound to the C-terminus of theExendin-4 derivative;or an Exendin-4 derivative of the sequence

H-(Lys)6-des Pro36 [Asp28] Exendin-4(1-39)-Lys6-NH2, des Asp28 Pro36,Pro37, Pro38Exendin-4(1-39)-NH2, H-(Lys)6-des Pro36, Pro38 [Asp28]Exendin-4(1-39)-NH2, H-Asn-(Glu)5des Pro36, Pro37, Pro38 [Asp28]Exendin-4(1-39)-NH2, des Pro36, Pro37, Pro38 [Asp28]Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-des Pro36, Pro37, Pro38 [Asp28]Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Asp28]Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-des Pro36 [Trp(O2)25, Asp28]Exendin-4(1-39)-Lys6-NH2, H-des Asp28 Pro36, Pro37, Pro38 [Trp(O2)25]Exendin-4(1-39)-NH2, H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28]Exendin-4(1-39)-NH2, H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Trp(O2)25,Asp28] Exendin-4(1-39)-NH2, des Pro36, Pro37, Pro38 [Trp(O2)25, Asp28]Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-des Pro36, Pro37, Pro38 [Trp(O2)25,Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5-des Pro36, Pro37, Pro38[Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-des Pro36[Met(O)14, Asp28] Exendin-4(1-39)-Lys6-NH2, des Met(O)14 Asp28 Pro36,Pro37, Pro38 Exendin-4(1-39)-NH2, H-(Lys)6-desPro36, Pro37, Pro38[Met(O)14, Asp28] Exendin-4(1-39)-NH2, H-Asn-(Glu)5-des Pro36, Pro37,Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-NH2, des Pro36, Pro37, Pro38[Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-des Pro36, Pro37,Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5 desPro36, Pro37, Pro38 [Met(O)14, Asp28] Exendin-4(1-39)-(Lys)6-NH2,H-Lys6-des Pro36 [Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-Lys6-NH2,H-des Asp28 Pro36, Pro37, Pro38 [Met(O)14, Trp(O2)25]Exendin-4(1-39)-NH2, H-(Lys)6-des Pro36, Pro37, Pro38 [Met(O)14, Asp28]Exendin-4(1-39)-NH2, H-Asn-(Glu)5-des Pro36, Pro37, Pro38 [Met(O)14,Trp(O2)25, Asp28] Exendin-4(1-39)-NH2, des Pro36, Pro37, Pro38[Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-desPro36, Pro37, Pro38 [Met(O)14, Trp(O2)25, Asp28]Exendin-4(S1-39)-(Lys)6-NH2, H-Asn-(Glu)5-des Pro36, Pro37, Pro38[Met(O)14, Trp(O2)25, Asp28] Exendin-4(1-39)-(Lys)6-NH2;

or a pharmaceutically acceptable salt or solvate of any one of theafore-mentioned Exedin-4 derivative.

Hormones are for example hypophysis hormones or hypothalamus hormones orregulatory active peptides and their antagonists as listed in RoteListe, ed. 2008, Chapter 50, such as Gonadotropine (Follitropin,Lutropin, Choriongonadotropin, Menotropin), Somatropine (Somatropin),Desmopressin, Terlipressin, Gonadorelin, Triptorelin, Leuprorelin,Buserelin, Nafarelin, Goserelin.

A polysaccharide is for example a glucosaminoglycane, a hyaluronic acid,a heparin, a low molecular weight heparin or an ultra low molecularweight heparin or a derivative thereof, or a sulphated, e.g. apoly-sulphated form of the above-mentioned polysaccharides, and/or apharmaceutically acceptable salt thereof. An example of apharmaceutically acceptable salt of a poly-sulphated low molecularweight heparin is enoxaparin sodium.

Pharmaceutically acceptable salts are for example acid addition saltsand basic salts. Acid addition salts are e.g. HCl or HBr salts. Basicsalts are e.g. salts having a cation selected from alkali or alkaline,e.g. Na+, or K+, or Ca2+, or an ammonium ion N+(R1)(R2)(R3)(R4), whereinR1 to R4 independently of each other mean: hydrogen, an optionallysubstituted C1 C6-alkyl group, an optionally substituted C2-C6-alkenylgroup, an optionally substituted C6-C10-aryl group, or an optionallysubstituted C6-C10-heteroaryl group. Further examples ofpharmaceutically acceptable salts are described in “Remington'sPharmaceutical Sciences” 17. ed. Alfonso R. Gennaro (Ed.), MarkPublishing Company, Easton, Pa., U.S.A., 1985 and in Encyclopedia ofPharmaceutical Technology.

Pharmaceutically acceptable solvates are for example hydrates.

These and further concepts of the invention will be apparent from andelucidated with reference to the detailed description presentedhereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of an embodiment of a systemaccording to the third aspect of the present invention;

FIG. 2 is a schematic block diagram of an embodiment of a medicalapparatus according to the first aspect of the present invention;

FIG. 3 is a schematic block diagram of an embodiment of an apparatusaccording to the second aspect of the present invention;

FIG. 4a is a flowchart of an embodiment of a method according to thefirst aspect of the present invention;

FIG. 4b is a flowchart of a further embodiment of a method according tothe first aspect of the present invention;

FIG. 4c is a flowchart of an embodiment of a method according to thesecond aspect of the present invention;

FIG. 4d is a flowchart of further method steps performed in anembodiment of a method according to the first aspect of the presentinvention;

FIG. 5 is a schematic block diagram that illustrates an information flowand a processing according to an embodiment of the present invention

FIG. 6 is a flowchart that illustrates an information flow and aprocessing according to a further embodiment of the present invention;and

FIG. 7 is a schematic illustration of a tangible storage mediumaccording to an embodiment of the present invention.

DETAILED DESCRIPTION

In the following detailed description, exemplary embodiments of thepresent invention will be described inter alia in the context of amedical apparatus comprising speech recognition means and a server. Itis however emphasized that deployment of the present invention in thistype of system is of exemplary nature only, since the present inventionis equally well applicable in various other contexts.

FIG. 1 is a schematic illustration of an embodiment of a systemaccording to the third aspect of the present invention. The systemcomprises at least one medical apparatus 1 and a server 2 that areconfigured to exchange information with each other.

FIG. 2 is a schematic block diagram of an embodiment of medicalapparatus 1 (see FIG. 1). Medical apparatus 1 comprises a processor 10,which may for instance be a microprocessor, a Digital Signal Processor(DSP), an Application Specific Integrated Circuit (ASIC), a FieldProgrammable Gate Array (FPGA) or the like. Processor 10 executesprogram code (e.g. software or firmware) stored in a program memory 11,and uses a main memory 12, for instance to store intermediate results.

Program memory 11 and/or main memory 12 may be used to store at least apart of operational data and/or to keep an operating and/or determiningrecord. Program memory 11 may for instance be a Read-Only Memory (ROM),and main memory 12 may for instance be a volatile or a non-volatilememory such as a Random Access Memory (RAM), a Flash-Memory or the like.

Processor 10 receives input from a user instruction sensor 13, which isfor instance a sensor configured to capture a signal inputted on akeyboard, a touch-screen device, an adjustment wheel, a button, and/orthe like. The processor 10 may receive further input from a visualsensor (for instance a camera, an acoustical sensor (for instance one ormore microphones), and/or from a different/separate/other device.

The user instruction is sensed by user instruction sensor 13. Arepresentation of the user instruction is then forwarded to processor10.

For instance, user instruction sensor 13 may comprise a microphoneconfigured to sense a speech instruction spoken by a user of medicalapparatus 1. The input received by processor 10 may then for instance bean electronic signal corresponding to an acoustical representation ofthe acoustical signal sensed by the microphone. Alternatively, theelectronic signal may for instance correspond to a sampled and quantizedand subsequently encoded acoustical representation of the acousticalsignal sensed by the microphone. This sampling, quantization andencoding may for instance be performed by an additional processor ofuser instruction sensor 13. Alternatively, the sampling, quantizationand encoding may be performed by processor 10. The sensed acousticalsignal comprises the actual speech instruction and for instancebackground noise or the like.

Optionally (not shown in FIG. 2), processor 10 may receive input from atleast one further user instruction sensor (for instance a different typeof sensor), at least one user parameter sensor configured to sense abiometric parameter of the user (for instance a blood pressure sensor, ablood glucose meter, or the like) and/or at least one medical apparatusparameter sensor configured to sense a status parameter of medicalapparatus 1. For instance, processor 10 may receive input from amicrophone and from a sensor configured to capture a signal inputted ona touch-screen device.

Processor 10 further controls a presentation unit 15 comprising at leastone of a visual signal generator (for instance a display device, anindicator light, etc.), an acoustical signal generator (for instance aspeaker, a buzzer, etc.), a mechanical signal generator (for instance avibrator, a Braille display, etc.) and the like.

Optionally (not shown), presentation unit 15 may comprise more than onesignal generator (for instance signal generator of different types). Forinstance, presentation unit 15 comprises a display device configured tovisually present information, such as a touch-screen device, and aspeaker configured to generate a speech signal.

Furthermore, processor 10 controls a communication unit 14, which is forinstance configured to transmit and/or receive information to/from oneor more other devices in a wireless fashion. Such transmission may forinstance be based on radio transmission or optical transmission.Alternatively, communication unit 14 may be configured to transmitand/or receive information to/from another device in a wire-boundfashion, for instance via a cable or fibre connection, both of which mayfor instance be fixed or releasable. For instance, communication unit 14may be configured to transmit information (for instance information ofthe operating and/or determining record) to server 2 and to receiveinformation (for instance modification information) therefrom.

FIG. 3 is a block diagram of an embodiment of server 2 (see FIG. 1).Server 2 comprises a processor 20, which may for instance be embodied asalready explained for processor 10 of medical apparatus 1 above.Processor 20 executes program code (e.g. software or firmware) stored ina program memory 21, and uses a main memory 22, for instance to storeintermediate results. Program memory 21 and main memory 22 may forinstance be embodied as already explained for program memory 11 and mainmemory 12 of medical apparatus 1 above.

Furthermore, processor 20 controls a communication unit 23, which is forinstance configured to transmit and/or receive information to/from oneor more other devices in ways already described with reference tocommunication unit 14 of medical apparatus 1 above. For instance,communication unit 23 may be configured to receive information (forinstance information of the operating and/or determining record ofmedical apparatus 1) from medical apparatus 1 and to transmitinformation (for instance modification information) thereto. Thereceived information may then for instance be stored in main memory 22.

It is to be noted that the circuitry formed by the components of medicalapparatus 1 of FIG. 2 and server 2 of FIG. 3 may be implemented inhardware alone, partially in hardware and in software, or in softwareonly.

FIGS. 4a-4d are flowcharts of embodiments of methods according to thefirst and second aspect of the present invention.

FIG. 4a shows method steps of a flowchart 300 for determining aninstruction operable by medical apparatus 1. These method steps may forinstance be performed by processor 10 of medical apparatus 1 and may forinstance be stored in program memory 11 of medical apparatus 1.

Flowchart 300 starts for instance when the medical apparatus is turnedon or is otherwise activated.

In a step 301, an instruction given by a user is sensed, for instance byuser instruction sensor 13 of medical apparatus 1 (see FIG. 2). In astep 302, an instruction operable by medical apparatus 1 (i.e. operableinstructions) is then determined based on a representation of theinstruction given by the user and sensed in step 301.

For instance, the instruction given by the user may be a speechinstruction spoken by the user. Accordingly, the determining of theinstruction operable by medical apparatus 1 may at least partially bebased on speech recognition. Therein, speech recognition may forinstance relate to the recognition and/or interpretation of theacoustical representation of the speech instruction spoken by the user.This may for instance comprise transcribing the acousticalrepresentation into a text-based representation.

The recognition and/or interpretation may for instance depend onoperational data such as interpretation and/or recognition rules thatare for instance at least partially based on an acoustic model and/or alanguage model and/or a wordbook.

For instance, the recognition and/or interpretation may firstly comprisethe identification of sound patterns associated with single words and/orsyllabuses in the speech instruction by use of the acoustic model andthe wordbook, wherein several word alternatives may be identified.Secondly, based on the language model, the most probable sequence ofwords is determined. A text-based representation of the speechinstruction may represent the sequence of words determined to be mostprobable.

Furthermore, the text-based representation may be mapped to aninstruction (for instance an instruction from a limited set ofinstructions) operable by medical apparatus 1 that causes medicalapparatus 1 to perform a related action. Alternatively, the acousticalrepresentation of the speech signal given by the user, or parts thereof,may be directly mapped to an instruction operable by the medicalapparatus in the process of speech recognition. Mapping may for instancebe performed by calculating the best matching instruction operable bymedical apparatus 1. The mapping may be based on mapping rules comprisedin the operational data.

For instance, by comparing the (acoustical and/or text-based)representation with a set of pre-defined representations and calculatingthe best matching pre-defined representation, the pre-definedrepresentations may be associated with respective instructions operableby the medical apparatus. Therein, the pairs of pre-definedrepresentations and respective instructions are for instance part of themapping rules.

The calculation may for instance further or alternatively be based on atleast one sensed biometric parameter of the user and/or at least onesensed status parameter of medical apparatus 1.

Optionally, determining of the operable instruction may comprise userrecognition (for instance speaker recognition). User recognition may forinstance be necessary to determine if general operational data oruser-specific operational data should be used. Therein, user-specificoperational data such as user-specific interpretation rules may forinstance provide improved speech recognition, since the speechrecognition may for instance be adapted to the specific articulation ofa specific user.

In a step 303, the success of step 302 is evaluated.

In the context of the above example, if the calculated best matchinginstruction has a low-matching score or if the sequence of wordsdetermined most probable is rather less probable, the determining may beconsidered to have failed. This may for instance be the case when thesensed acoustical signal comprises a speech instruction which isdisturbed by a high noise level, so that the speech instruction is notrecognizable by speech recognition. Equally well, speech recognition mayfail in case that a speech instruction does not have a matchinginstruction operable by the medical apparatus, for instance because thespeech instruction uses a rare/unusual vocabulary.

A definition of “low matching score” or “rather less probable” may forinstance be given in the mapping and/or interpretation rules that mayfor instance be comprised in the operational data.

If the determining of step 302 was unsuccessful, in a step 304, the useris requested to repeat his previously given instruction.

For instance, the user may be requested to repeat a non-recognizablespeech instruction acoustically. Alternatively, the user may berequested to repeat the non-recognizable speech instruction visuallyand/or manually.

So, if it is determined that a repetition of a non-recognizable speechinstruction will result in another unsuccessful attempt of determiningan instruction operable by medical apparatus 1, the user may forinstance be requested to input the respective instruction on atouch-screen device, a keyboard or the like, or to spell the instructionletter-by-letter, to give but a few examples. The number of unsuccessfulrecognitions triggering a change of the way the instruction can be givenby the user may be defined by a threshold value (which is 2 in the aboveexample), which may be pre-defined or adaptively determined, forinstance based on statistics of the present interaction process and/orone or more previous interaction processes (either with respect to thepresent user or with respect to a variety of users).

Alternatively, different instruction alternatives may be presented tothe user. For instance, the first, second and third best matchinginstructions operable by the medical apparatus may be presented to theuser, who can simply choose one of the alternatives, for instance byspeaking a single speech instruction, or by selecting an alternative bytouching it on a touch-screen device.

For instance, the user may choose one of the presented instructionalternatives by speaking a single (and thus simply recognizable) speechinstruction, e.g. a number associated with the instruction alternative,such as “one”, “two” or “three”. Alternatively, the user may repeat thespeech instruction as requested.

In response to step 304, a user instruction is sensed (step 301), andthe method restarts with step 301.

In the case that the determining of the instructions operable by medicalapparatus 1 is successful, step 303 is followed by a step 305, in whichthe determined instruction operable by medical apparatus 1 is (forinstance acoustically and/or visually) presented to the user. In a step306, the user is then requested to confirm the determined instruction.

For instance, the user may confirm the determined instruction bypressing a button, by speaking a single speech instruction, such as“yes” or “ok”, or by performing an action on medical apparatus 1 (forinstance on a touch-screen thereof). If the user does not confirm thedetermined instruction, the user is requested to correct the determinedinstruction and/or to repeat his previously given instruction (step304). Thereafter, the method restarts with step 301.

However, if the determined operable instruction is confirmed, medicalapparatus 1 is caused to perform the operable instruction in a step 307.

Optionally, information related to the steps of flowchart 300, such asthe representation of the instruction given by the user (step 301), thedetermined instruction operable by medical apparatus 1 (302), therepresentation of the repeated instruction given by the user (steps 304,301), sensed biometric parameters and/or sensed medical apparatusparameters, are stored in the operating and/or determining record.

For instance, the acoustical and/or text-based representation of aspeech instruction spoken by the user, the respectively determinedinstruction, and the respective corrected determined instruction (ifcorrection was necessary, see steps 306, 304, 301) may be stored in theoperating and/or determining record.

FIG. 4b shows method steps of a flowchart 400 for operating aninteraction process. These method steps may for instance be performed byprocessor 10 of medical apparatus 1 and may for instance be stored inprogram memory 11 of medical apparatus 1.

In a step 401, an action performed by a user of medical apparatus 1 issensed. Such an action may for instance be an instruction given by theuser, or it may for instance be an action causing a change of the statusof medical apparatus 1, such as a turning medical apparatus 1 on.

In a step 402, a reaction that is to be performed by medical apparatus 1in response to the action sensed in step 401 is determined, at leastpartially based on information associated with the sensed action.

For instance, if the sensed action is a speech instruction spoken by theuser, the determining of the reaction may at least partially be based onspeech recognition. Therein, speech recognition may for instance relateto the recognition and/or interpretation of the respective acousticalrepresentation of the speech instruction spoken by the user, asdescribed above.

Furthermore, a representation of the recognized speech instruction (forinstance a text-based representation) may then be mapped to a reactionthat is performable by medical apparatus 1. Alternatively, theacoustical representation of the speech instruction, or parts thereof,may be directly mapped to a reaction that is performable by medicalapparatus 1.

Determining of the reaction may for instance at least partially be basedon calculating the best matching reaction performable by medicalapparatus 1. The calculation may be based on flow rules comprised in theoperational data.

In the context of a spoken speech instruction, for instance anacoustical and/or text-based representation of the speech instruction iscompared with a set of pre-defined representations and the best matchingpre-defined representation is calculated. The pre-definedrepresentations may be associated with respective reactions performableby the medical apparatus; and the pairs of pre-defined representationsand respective reactions are for instance part of the flow rules.

The calculation may for instance further or alternatively be based on atleast one sensed biometric parameter of the user, at least one sensedstatus parameter of medical apparatus 1 and/or at least one previouslysensed action and/or reaction.

The flow rules may for instance define how an interaction between themedical apparatus and the user is structured, for instance, what actionsand/or instructions are requested and/or expected from the user, and inwhich sequence.

A determined reaction that is performable by medical apparatus 1 may forinstance be the presentation of information (for instance by generatinga speech signal), or the change of the status of medical apparatus 1, toname but a few examples.

In a step 403, the medical apparatus is caused to perform the determinedreaction; and in a step 404, it is determined whether the interactionprocess is to be continued.

Optionally, information related to the steps of flowchart 400, such as arepresentation of the flow of the interaction process and/orrepresentations of the actions performed by the user in the course ofthe flow (step 401), the determined actions performable by medicalapparatus 1 (step 402), sensed biometric parameters and/or sensedmedical apparatus parameters, are stored in the operating and/ordetermining record.

For instance, if an interaction process, such as a dialog for preparingthe injection of a medicament (such as for instance insulin) by medicalapparatus 1, requires the user to perform different actions, the user issequentially requested to do so. In this case, the user may firstly berequested to change the needle or needle device of the injection device.As soon as a needle-change (i.e. a status change) is sensed, the usermay be asked to perform a priming shot (and/or a safety shot and/or asafety test). After the priming shot the user is requested to give aninstruction (for instance a speech instruction) with respect to thedesired dose of insulin that is to be ejected. Thereafter, the user isrequested to confirm the accordingly determined dose (which may forinstance be determined at least partially by speech recognition). When aconfirmation is sensed, the determined dose is ejected by medicalapparatus 1. Thus, several reactions and actions depending on theprevious reactions and actions are part of this exemplary interactionprocess and, thus, the method steps 401-404 are repeated several times.

FIG. 4c shows a flowchart 500 with method steps that are for instanceperformed by processor 20 of server 2 (see FIG. 3) and may for instancebe stored in program memory 21 of server 2.

In a step 501, information of an operating and/or determining record isreceived, for instance from medical apparatus 1.

The received information comprises at least one representation of atleast one instruction given by a user of medical apparatus 1. Forinstance, an acoustical representation of a speech instruction spoken bythe user (see step 301 of FIG. 4a ) and/or a respective text-basedrepresentation (see step 302 of FIG. 4a ) may be received.

Optionally, the received information may comprise further informationabout at least one previous interaction process (for instance respectiverepresentations of actions (see step 401 of FIG. 4b ) and reactions (seestep 402 of FIG. 4b ) of such an interaction process), furtherrespective representations of instructions given by at least one userand respectively determined instructions, medical data (for instancedate and dose of injections performed by an injection device),user-specific data, data about device failures and user errors, generaldata, and/or the like.

In a step 502, the received information is analyzed, and in a step 503,modification information is determined at least partially based on theanalysis of the information.

In the context of at least partially speech-based control of medicalapparatus 1, for instance a representation of at least one speechinstruction spoken by the user and not recognized by medical apparatus 1(for instance due to unclear pronunciation of the user and/or due touncommon use of nomenclature) may be analyzed to determine aninstruction operable by the medical apparatus that matches theinstruction given by the user. The modification information may then bedetermined accordingly to ensure that the same instruction given by theuser is recognized by the medical apparatus in the future.

Furthermore, the analysis may for instance also or alternativelycomprise comparing the instruction determined by server 2 with aninstruction determined by the medical apparatus 1 in response to thesame representation of an instruction given by the user, for instance todetect erroneous or non-optimum decisions made by medical apparatus 1.To this end, information (e.g. a representative code) on the respectiveinstruction determined by medical apparatus 1 has to be provided toserver 2 that performs the analysis. The modification information maythen be determined to avoid erroneous or non-optimum decisions of themedical apparatus 1 in the future.

The analysis may for instance further or alternatively comprisecomparing a representation of an instruction given by a user of medicalapparatus 1 in the flow of an interaction process with anotherrepresentation of an instruction given by the user in the flow of aprevious interaction process, or processing representations of aninstruction given by one or more users of one or more medicalapparatuses in several interaction processes (for instance in responseto the same question asked to the at least one user in the interactionprocess). Such information may for instance be analyzed to determine aset of instructions frequently given by the user or users of the medicalapparatus 1 (or by users of identical or at least functionally similarmedical apparatuses) and may be considered when determining modificationinformation, so that for instance the most frequent of all instructionsgiven by the user(s) so far can be recognized by the medical apparatus 1in the future. Alternatively, the most frequent of all instructions maybe presented as instruction alternatives to the user, so that the usermay for instance respond with a single (and thus simply recognizable)speech instruction, such as “one”, “two”, or “three”.

The modification information may comprise information for modifying theoperational data generally (i.e. for all users) and/or for modifying theoperational data for a specific user (for instance to adapt the speechrecognition to a specific articulation that is characteristic for theuser) or for a specific group of users.

The determining of the modification information may further be based ona server-side copy of the operational data stored in medical apparatus1, so that the determined modification information for instancecomprises only modified parts of the operational data. Alternatively,the information received from medical apparatus 1 may comprise theentire operational data, and/or the transmitted modification informationcomprises the entire modified operational data, although only partsthereof may have been actually modified.

FIG. 4d shows a flowchart 550 with method steps that are for instanceperformed by processor 10 of medical apparatus 1 (see FIG. 1) and mayfor instance be stored in program memory 11 of medical apparatus 1.

In a step 551, modification information is received, for instance fromserver 2.

As described above, the modification information may compriseinformation for modifying the operational data generally (i.e. for allusers) and/or for modifying the operational data for a specific user(for instance to adapt the speech recognition to a specific articulationthat is characteristic for the user).

In a step 552, the operational data is then modified based on thereceived modification information.

Therein, the modification information may comprise instructions that arefor instance operable by processor 10 or by another processing unit (forinstance by a processor comprised in a modification unit) for modifyingthe operational data. These instructions are for instance for replacingat least a part of the operational data (for instance with datacomprised in the modification information), for deleting at least a partof the operational data, and/or for adding new data (for instancecomprised in the modification information) to the operational data.

Optionally, the received modification information are analyzed, so thatit may for instance be determined whether the modification of theoperational data is performed for all users, or for a specific group ofusers, or for a specific user. For instance, the operational data maycomprise general interpretation and mapping rules for all users andsupplementary and/or alternative interpretation and mapping rules for atleast one specific user or at least one group of specific users.However, if medical apparatus 1 is only used by one specific user, onlyinterpretation and mapping rules for the specific user may be maintainedwhen modification information is received.

FIG. 5 is a schematic block diagram that illustrates an embodiment of aninformation flow and processing in system 3 (see FIG. 1) of the presentinvention. Therein, components that have the same function as componentsalready shown in FIGS. 2 and 3 have been assigned the same referencenumerals.

An instruction given by a user (for instance a speech instruction) issensed by user instruction sensor 13 comprised in medical apparatus 1.User instruction sensor 13 forwards an electronic signal correspondingto a representation of the instruction (for instance an acousticalrepresentation of the speech instruction) to processor 10.

Processor 10 comprises an interpretation unit 10-1 and a mapping unit10-2 for performing the determining of an instruction operable bymedical apparatus 1 based on the forwarded representation, onoperational data 12-1 and optionally on one or more user parameterssensed by user parameter sensor 17. In particular, determining theinstruction operable by medical apparatus 1 may for instance beperformed as described above.

Interpretation unit 10-1 performs recognition and/or interpretation onthe forwarded representation according to interpretation rules 12-11(for instance according to general and/or user specific interpretationrules) comprised in operational data 12-1, and outputs an interpretedrepresentation of the user instruction (for instance a text-basedrepresentation of the speech instruction).

This interpreted representation is then used by mapping unit 10-2 to mapthe representation of the instruction given by the user with thebest-matching instruction operable by medical apparatus 1. The mappingis performed according to mapping rules 12-12 (for instance generaland/or user specific mapping rules) comprised in operational data 12-1.

The determined operable instruction is then communicated to presentationunit 15 configured to present the determined instruction to the user(for instance by generating a corresponding speech signal). Optionally(not shown), processor 10 may further or alternatively cause medicalapparatus 1 to perform a related action.

Additionally, the representation of the user instruction, theinterpreted representation of the user instruction, the determinedoperable instruction and the optionally sensed user parameter arerecorded in operating and/or determining record 12-2.

Both, operational data 12-1 and operating and/or determining record 12-2may for instance be comprised in main memory 12 shown in FIG. 2.

This information of operating and/or determining record 12-2 is thencommunicated to server 2.

Processor 20 of server 2 comprises an analyzing unit 20-1 for analyzingthe communicated information of determining and/or operating record12-2; and it further comprises a determining unit 20-2 configured toperform determining modification information at least partially based onthe analysis. Furthermore, the determining modification information mayfurther or alternatively be based on the operational data, a server-sidecopy of the operational data, previously communicated information ofoperating and/or determining record 12-2 and/or information of operatingand/or determining record communicated from further medical apparatuses.In particular, the analysis of the communicated information and thedetermining of the modification information may be performed asdescribed above.

The determined modification information is then communicated tomodification unit 16 of medical apparatus 1, which is for instancecomprised in processor 10, or which is a separate processing unit.Modification unit 16 is configured to modify operational data 12-1, suchas interpretation rules 12-11 and mapping rules 12-12 according toinstructions comprised in the determined modification information.

Optionally, modification unit 16 may for instance be further configuredto modify the operational data in an interaction process or upon one ormore instructions given by a user, such as a specific user. The userthen may for instance use a user interface of medical apparatus 1 formodifying the operational data 12-1.

FIG. 6 is a flowchart 600 that illustrates an information flow andprocessing according to an embodiment of the present invention.

In a step 601, the user gives the speech instruction “dial 5 units ofinsulin”.

This speech instruction is sensed by medical apparatus 1 in a step 602.However, in a step 603, the related instruction operable by the medicalapparatus is wrongly determined to “dial 3 units of insulin”, forinstance due to unclear pronunciation of the user instruction, inparticular of the word “5”.

In a step 604, the wrongly determined instruction is then presented tothe user, who accordingly corrects the wrongly determined instruction,for instance by moving an adjustment wheel to a position correspondingto the instruction “dial 5 units of insulin”.

In a step 606, the position of the adjustment wheel is then sensed bymedical apparatus 1; and in a step 607 the instruction operable by themedical apparatus is correctly determined to “dial 5 units of insulin”.

Optionally, the correctly determined instruction may then be presentedto the user, who may confirm the correctly determined instruction.

In a step 608, the correctly determined 5 units of insulin are thenejected by medical apparatus 1.

In a step 609, the representation of the speech instruction sensed instep 602 and the in step 603 wrongly determined instruction and/or therepresentation of the instruction sensed in step 606 and/or theinstruction determined correctly in step 607 may be stored in anoperating and/or determining record. This information may then betransmitted (step 610) by medical apparatus 1 and received by server 2(step 611).

In a step 612, the received information may be analyzed; and in a step613 modification information may be determined. In this case, themodification information may for instance comprise information, so thatthe instruction wrongly determined in step 603 will be correctlydetermined in the future.

This modification information is transmitted from server 2 (step 614)and received by medical apparatus 1 (step 615).

In a step 615, the operational data is then modified accordingly.

For instance, the user may have a specific articulation of the number“5”, so that the general acoustic model or a user specific acousticmodel that may initially be comprised in the interpretation rules may bemodified according to information comprised in the received modificationinformation. Alternatively, the speech instruction (sensed in step 602)may comprise a word, which is not comprised in the word-book comprisedin the interpretation rules, so that the word-book may be updatedaccording to the received information.

FIG. 7 is a schematic illustration of an embodiment of a tangiblestorage medium 73 that comprises a computer program 72 with program code73 according to an embodiment of the present invention. This programcode may for instance be executed by processors contained in medicalapparatus 1, for instance processor 10, but also processor 20 containedin server 2. For instance, storage medium 73 may represent programmemory 11 of medical apparatus 1 or program memory 21 of server 2.Storage medium 73 may be a fixed memory, or a removable memory, such asfor instance a memory stick or card. Tangible storage medium 73 is anon-transitory storage medium.

It should also be understood that the sequence of method steps in theflowcharts presented above is not mandatory, also alternative sequencesmay be possible. All functional blocks of apparatuses shall also beunderstood as a disclosure of a corresponding method step, andsimilarly, each method step shall be considered as a disclosure of acorresponding functional unit of an apparatus. It is well understoodthat the method steps and functional components can be implemented invarious ways either in hardware only, or in software only, or in acombination of hard- and software.

1. A medical apparatus, comprising: a processor configured to perform atleast one of operating an interaction process with a user of saidmedical apparatus and determining, based on a respective representationof at least one instruction given by said user, at least one instructionoperable by said medical apparatus, wherein said at least one of saidoperating an interaction process and said determining at least oneinstruction at least partially depends on operational data; acommunication unit configured to receive modification information formodifying at least a part of said operational data, said modificationinformation at least partially determined based on an analysis of arespective representation of at least one instruction given by a user.